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I visited the AC supermarket in Utqiagvik, the town formerly known as Barrow.

It could be anywhere USA, with anything you could possibly want, including fresh blueberries from Argentina. How’s that for food miles?

Remember: all of this, no exceptions, comes in by cargo plane.

The produce section was lovely, with remarkably fresh foods at equally remarkable prices.

Would you believe the green leaf lettuce is $3.50, the baby carrots $7.29, and the romaine $4.69? New York prices on steroids.

How about white potatoes at $3.29, red ones at $2.79, and baking potatoes at $18.99 for 10 pounds.

Or the reason I was so concerned about the tossed out school lunch milk cartons: $7.11 on sale.

How about bread on sale for $5.98 a loaf?

Just to make me feel at home, here are the sugary drinks down one entire aisle. The 12-packs were on sale for $10.98, which must not be enough to discourage sales.

Are soft drinks a problem in Utqiagvik/Barrow?

Yes, they are.

The prevalence of obesity and diabetes is low, but rising steadily, and the Indian Health Service dentists told me that they see plenty of little kids with rotted teeth from drinking sodas and sweet juices in baby bottles.

The nutrition transition is taking place in America too, and for the same reasons that obesity and diabetes are becoming problems in the developing world.

We’ve been telling people to lose weight, eat more complex carbs and do more exercise for years to get their blood sugar under control, but the number of Americans with type two diabetes continues to rise at an alarming rate. So how can the food industry help? In this FoodNavigator-USA special edition we explore the growing number of tools in the formulator’s toolbox to help promote healthy blood sugar. We also look at what messages resonate with consumers, from the glycemic index to healthy blood sugar, plus what you can, and can’t, say about diabetes on a food label.

I spent a lot of time last week talking to reporters about the widely publicized study in PloS One that correlates sugar and diabetes.

The study is based on an econometric model of data food availability and diabetes prevalence in many countries. Such data are not particularly reliable, but the authors did the best they could with what they had. They are quite forthcoming about the limitations of their model and the data on which it is based [see addition below].

Their principal conclusion: for every 150 kcal/person/day increase in sugar availability (about one can of soda/day), diabetes prevalence increases by about 1%.

Because no other dietary, weight, or behavioral factor shows this kind of effect in their model, it is tempting to interpret the study as demonstrating that sugar is a risk factor for diabetes independent of calorie intake or body weight.

I’m not so sure. Take a look at the summary figures and decide for yourself.

Figure 1. Relationship between obesity and worldwide prevalence of diabetes.

Despite outliers, this figure shows an obvious and strong correlation between obesity and diabetes. Compare this to Figure 2.

The correlation here is much less obvious. Without statistical tests, you could just as easily draw the line straight across the graph. The statistical significance is much weaker than that in Figure 1.

This means that these data cannot easily distinguish between several possibilities:

(a) Calories –> Obesity –> Diabetes

(b) Sugar –> Diabetes

(c) Sugar –> Calories –> Obesity –> Diabetes

While waiting for science to clarify these distinctions, the bottom line is the same for all of them.

As I explained in yesterday’s post, everyone would be healthier eating less sugar.

Q: I have been diagnosed with type 2 diabetes and am very confused about insulin resistance, and what carbohydrates I can and cannot eat. So much of what I read is contradictory.

A: The first line of defense against type 2 diabetes is weight loss, but you would never know it from listening to Paula Deen, the celebrity Southern cook who recently announced that she has this disease, or even to the American Diabetes Association.

Having diabetes is no joke. It is a leading cause of blindness, kidney failure, leg and foot amputations, and premature death.

The disease comes in two forms – type 1 and type 2 – but type 2 accounts for 95 percent of cases. In both, levels of blood sugar are too high as a result of problems with insulin, a hormone that enables the body to use blood sugar for energy. But the reasons differ.

Type 1 is an autoimmune disease. It causes the pancreas to stop making insulin or not make enough. Type 1 is not yet preventable and requires insulin treatment.

In type 2, insulin may be available, but body tissues resist its use.

Being overweight is the key factor in type 2. Most people can prevent it by not gaining weight. And most people with the type 2 disease can eliminate symptoms by losing some weight.

Genetics is certainly a factor – many overweight people never develop the disease – but 85 percent or more of people diagnosed with type 2 diabetes are overweight or obese.

In genetically predisposed people, being overweight causes insulin resistance. Metabolism does not handle excess calories very well, and this means calories from any source, not just carbohydrates.

Fast food, soft drinks

Children and adults who habitually consume fast food as well as soft drinks tend to take in more calories and weigh more and are more likely to develop symptoms than people who eat healthier diets and are more active.

This makes healthy eating and physical activity the most important approaches. The vast majority of overweight people at risk of type 2 diabetes can prevent symptoms by losing a few percent of their body weight and doing a couple of hours a week of moderate – not necessarily vigorous – physical activity. The same works for treatment. Some people will still need medications, but the drugs work better with diet and physical activity.

As the Centers for Disease Control puts it, “all diabetes-care programs should make healthy weight a priority.”

Dietary advice for type 2 diabetes is the same as advice for everyone else: Eat a wide variety of relatively unprocessed foods, especially vegetables, fruits and whole grains, and don’t consume too much junk food or too many sugary beverages.

Scientists may argue endlessly about the relative importance of calories, sugars and refined carbohydrates in the diets of people with type 2 diabetes, but everyone agrees that eating less of all three would help resolve symptoms.

The ADA does talk about weight loss on its website ( www.diabetes.org), but you must search hard through several complicated screens before you find, “Losing just a few pounds through exercise and eating well can help with your diabetes control and can reduce your risk for other health problems.”

Pharmaceuticals

I can’t help wondering if the lack of prominence given to weight loss might have something to do with the influence of pharmaceutical companies.

A few years ago, I gave a talk on the importance of weight loss in control of type 2 diabetes at an ADA annual meeting. Although many conference talks dealt with drug treatment, mine was the only one on diet – except for a session on sugars sponsored by Coca-Cola.

But a diagnosis of type 2 diabetes should be a teachable moment. Shouldn’t the ADA more strongly urge people with the disease to eat less, eat better and move more, and help everyone find ways to cope with “eat more” messages?

The health and economic costs of type 2 diabetes, and its preventability, are reason enough to demand changes in the food environment. The ADA should be working hard to make it easier for everyone to eat more healthfully, be more active and avoid the need for a lifetime of diabetes medications.

Marion Nestle is the author of “Food Politics” and “What to Eat,” among other books, and is a professor in the nutrition, food studies and public health department at New York University. She blogs at www.foodpolitics.com. E-mail comments to food@sfchronicle.com.

According to the Times’ account, Mrs. Dean says that it is elitist to criticize her food:

You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills.

Really? Does Mrs. Deen think those families can afford to pay the $500 a month drug companies charge for Victoza?

Victoza costs in other ways too. It has to be injected and is not exactly benign.

Victoza® is not recommended as the first medication to treat diabetes. Victoza® is not insulin and has not been studied in combination with insulin…It is not known if Victoza® is safe and effective in children. Victoza® is not recommended for use in children

In animal studies, Victoza® caused thyroid tumors—including thyroid cancer—in some rats and mice. It is not known whether Victoza® causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early…Inflammation of the pancreas (pancreatitis) may be severe and lead to death.

The company also advises:

Victoza® is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes when used along with diet and exercise.

Diet and exercise? Why not just do that in the first place?

As for the American Diabetes Association: its disinterest in promoting diet and exercise is easily explained. It is funded by drug companies.

I gave a talk at an annual meeting of the Association a few years ago and was astounded by the number of drug companies giving things—writing pads, pens, and tape holders, but also lab coats and stethoscopes—at the trade exhibit. Much of the scientific meeting was devoted to drug studies. I spoke at the only session that year on dietary issues. And Coca-Cola sponsored a session on sugars in diabetes.

Mrs. Deen’s food is best eaten in moderation. She would do more for her own health and that of her fans if she used her television presence to promote healthier lifestyles.

As I mentioned in a previous post, the United Nations General Assembly met this month to consider resolutions about doing something to address rising rates of “non-communicable” diseases (i.e., chronic as opposed to infectious diseases such as obesity-related coronary heart disease, type 2 diabetes, and cancers).

The Declaration adopted by the Assembly disappointed a consortium of 140 non-profit public health advocacy groups who issued a statement noting the conflicts of interest that occur when international agencies “partner” with companies that make products that contribute to an increase in disease risks.”

The consortium suggested actions that they hoped the U.N. would recommend, such as: